Pharyngocutaneous fistula following laryngectomy.
BACKGROUND
Pharyngocutaneous fistula (PCF) following laryngectomy is a serious complication, and its incidence varies from 7.6% to 50%. Despite the relative frequency of this complication, there is still uncertainty about the predisposing factors.


METHODS
A retrospective study was performed in 295 patients who underwent total laryngectomy.


RESULTS
Of the 295 patients, 37 (12.5%) developed PCF. The contributing factors,--such as early oral feeding postoperatively, prior radiotherapy or tracheostomy, accompanying neck dissection,--and the surgical technique failed to show a statistically significant effect. There was statistically significant association between tumor size and PCF formation. Also, when the suture materials used for the closure of the pharynx were compared, catgut showed a higher rate of PCF formation than vicryl (p < .05).


CONCLUSIONS
The vicryl, when used as a suture material for the closure of the pharynx, seemed to decrease the fistula rate significantly, compared with catgut. Also, tumor stage was found to have a significant role in PCF formation, but no statistical significant difference could be demonstrated for other investigated parameters. We believe that after total laryngectomy, oral feeding can be started at the third postoperative day without increasing morbidity, which makes the patients feel more comfortable and confident without nasogastric tube.
Soylu
L
L
Department of Otolaryngology, Cukurova University Medical Faculty, Adana, Turkey.
Kiroglu
M
M
Aydogan
B
B
Cetik
F
F
Kiroglu
F
F
Akçali
C
C
Ozşahinoglu
C
C
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D002398:Catgut; D016009:Chi-Square Distribution; D017577:Cutaneous Fistula / Q000453:epidemiology / Q000209:etiology*; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010608:Pharyngeal Diseases / Q000453:epidemiology / Q000209:etiology*; D011098:Polyglactin 910; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013537:Sutures; D014421:Turkey / Q000453:epidemiology
D001672:Biocompatible Materials; D011098:Polyglactin 910